Tomimaru Yoshito, Sasaki Yo, Yamada Terumasa, Eguchi Hidetoshi, Ohigashi Hiroaki, Ishikawa Osamu, Imaoka Shingi
Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari-ku, Osaka 537-8511, Japan.
World J Surg. 2006 Sep;30(9):1729-35. doi: 10.1007/s00268-005-0123-9.
The relationship between the state of non-cancerous tissues in patients with hepatocellular carcinoma (HCC) who are negative for hepatitis B surface antigen (HBsAg), hepatitis B core antibody (HBcAb), and hepatitis C antibody (HCVAb) (NBNC-HCC) and the prognosis has not yet been resolved.
We examined the clinicopathological features of these patients and performed statistical analysis for the prognosis of recurrence following curative hepatic resection.
Disease-free survival (DFS) revealed that only the degree of fibrosis was a significant prognostic factor (P = 0.0374). On the basis of the degree of fibrosis (New Inuyama Classification), patients with NBNC-HCC were divided into a non-fibrotic liver group (NF group; F0, n = 10) and a fibrotic liver group (FL group; F1-4, n = 34). The DFS rate in the NF group was significantly better than that in the FL group (P = 0.0408). In the NF group, only one patient recurred, while in the FL group, 21 patients had recurrences. In the FL group, intra-hepatic recurrence was frequently seen in both lobes within 2 years after the initial hepatic resection, while recurrences more than 2 years after the initial operation were mainly seen in the contralateral lobe.
Histological assessment of the degree of fibrosis in the non-cancerous regions of NBNC-HCC may be useful not only for the selection of the appropriate treatment but also for the prediction of postoperative prognosis.
